Makino Yasushi, Nishiyama Osamu, Sano Hiroyuki, Iwanaga Takashi, Higashimoto Yuji, Kume Hiroaki, Tohda Yuji
Department of Respiratory Medicine and Allergology, Kinki University, Faculty of Medicine, Japan.
Intern Med. 2014;53(23):2737-9. doi: 10.2169/internalmedicine.53.2973. Epub 2014 Dec 1.
We herein present the case of a 64-year-old immunocompetent man with a diagnosis of pulmonary cryptococcosis who presented with cavitary nodules, one of which contained a fungus ball, on chest CT. The coincidence of cavitary cryptococcosis and an Aspergillus fungus ball was histologically confirmed on a thoracoscopic lung biopsy. Encapsulated round-to-oval yeasts (Cryptococcus) were observed throughout the entire specimen, including the cavity, cavity wall and lung parenchyma. In contrast, filamentous fungi (Aspergillus) were noted within the cavity only. The probable mechanism of this rare manifestation is that the Cryptococcus formed cavities, after which an Aspergillus fungus ball developed within one cavity.
我们在此报告一例64岁免疫功能正常的男性，诊断为肺隐球菌病，胸部CT显示有空洞性结节，其中一个含有真菌球。胸腔镜肺活检在组织学上证实了空洞性隐球菌病与曲霉菌真菌球的巧合。在整个标本中，包括空洞、洞壁和肺实质，均观察到有包膜的圆形至椭圆形酵母（隐球菌）。相比之下，仅在空洞内发现丝状真菌（曲霉菌）。这种罕见表现的可能机制是隐球菌形成空洞，之后在其中一个空洞内形成曲霉菌真菌球。
